Deprescribing: An Application to Medication Management in Older Adults

Area of Science:

• Pharmacology
• Geriatrics
• Clinical Pharmacy

Background:

• Polypharmacy increases risks of inappropriate medications, drug interactions, and adverse effects.
• Deprescribing offers a strategy to optimize medication regimens and enhance patient safety.
• Clinical pharmacists play a key role in managing complex medication use.

Purpose of the Study:

• To review the process of deprescribing.
• To apply deprescribing principles to high-priority medication classes.
• To provide evidence-based guidance for clinical pharmacists.

Main Methods:

• Literature search of PubMed and reference lists.
• Inclusion of relevant studies known to the author.
• Review and application of evidence to specific drug classes.

Main Results:

• Identified several medication classes as high priority for deprescribing guidelines.
• Applied the deprescribing process to statins, cholinesterase inhibitors, and bisphosphonates.
• Demonstrated the utility of evidence in deprescribing preventive medications.

Conclusions:

• Evidence supports applying deprescribing to common chronic disease medications.
• Deprescribing guidelines are crucial in the absence of existing clinical practice guidelines.
• This review aids clinical pharmacists in optimizing medication therapy through deprescribing.